Employees Jump at Genetic Testing. Is That a Good Thing?

While regulators called their decision a step forward in the availability of direct-to-consumer genetic screening, they explicitly warned that the test did not detect most mutations that increase breast cancer risk. They also warned consumers not to use the tests as a substitute for qualified medical care and genetic counseling.

Color, the genomics company, takes something of a middle road. It markets comprehensive medical diagnostic tests that screen for all mutations of certain genes known to be linked to certain kinds of heredity cancers and heart risks. It has doctors available to order its tests online for users and provides genetic counseling to discuss users’ results.

“By using genetics, you can help some people prevent or interrupt something at an earlier stage where the costs are much lower,” said Othman Laraki, chief executive of Color Genomics. The start-up advises users that they could develop major diseases even if their test results show no harmful mutations.

Executives at SAP and Nvidia said they hoped genetic screening might ultimately help prevent at least a few late-stage cancers, the kinds of life-threatening illnesses that can debilitate employees and cost companies with self-funded health plans more than $1 million in medical fees.

After Nvidia began offering free screening from Color last year, about 27 percent of its 6,000 eligible employees in the United States took the test. After SAP started subsidizing the genetic tests last year, about 17 percent of the company’s 30,000 eligible employees and family members participated.

Photo

A robotic testing machine at Color. A growing number of tech companies are offering genetic screening as a benefit just as federal health agencies, researchers, and physicians are wrangling over whether the tests are ready for widespread adoption.Credit
Jason Henry for The New York Times

“In the long-term view of a program like this, it’s going to pay for itself,” said Jason J. Russell, who oversees employee compensation and benefits for SAP North America. And, he added, “You are creating good will with employees.”

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Given the expense of screening more people of average risk — as well as follow-up costs from additional tests, medicines, surgery and potential complications from surgeries — experts said that overall medical expenditures were actually likely to increase. Even so, they said, spending on screening for conditions like hereditary high cholesterol, which increases risk for strokes and heart attacks before the age of 50, could ultimately prolong some lives.

“You are getting good preventive care value for money, ” said David L. Veenstra, a professor at the University of Washington who studies health outcomes and economics.

Color has raised $150 million from venture capital firms like General Catalyst as well as Bay Area tech luminaries including Max Levchin, a PayPal co-founder; Sundar Pichai, Google’s chief executive; and Laurene Powell Jobs, a philanthropist-investor who is the widow of the Apple co-founder Steve Jobs.

The company has reduced genetic testing costs by using robotics and machine learning and eliminating tasks like in-person prescreening by doctors. It charges $249 for hereditary risk screening for eight of the most common cancers and began offering that price while more established medical diagnostics firms were charging $4,000 for similar tests.

The price point appealed to OpenTable. It started offering genetic screening benefits after an employee with a history of cancers told executives she was spending thousands of dollars out of her own pocket to pay for hereditary risk tests.

“This was a really interesting opportunity to provide some choice to our employees that was accessible and affordable so they could better understand their own personal health,” said Christa Quarles, chief executive of OpenTable.

As for privacy concerns, executives at several companies said that Color regularly sent them aggregated data on the number of employees with harmful disease mutations, but that the data is not tied to identifying details like employees’ names or birth dates.

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As more large-scale research is conducted, medical recommendations may change. More than 150,000 patients, for instance, have enrolled in a DNA sequencing study at Geisinger Health, a medical center in Danville, Pa. And the federal advisory panel is updating its recommendation on genetic screening for certain breast cancer mutations.

Executives at several companies that have signed up with Color said they were aware of the debate over genetic screening, but said they believed the start-up was simply ahead of the curve.